Assessment of the impact of service charters on service delivery in Malawi: a case of Southern Region Water Board
- Authors: Ntelela, Rashid Friday
- Date: 2012
- Subjects: Water-supply -- Malawi , Water utilities -- Malawi , Municipal services -- Malawi , Local government -- Malawi
- Language: English
- Type: Thesis , Masters , MPA
- Identifier: vital:11624 , http://hdl.handle.net/10353/549 , Water-supply -- Malawi , Water utilities -- Malawi , Municipal services -- Malawi , Local government -- Malawi
- Description: Malawi is divided into three regions, namely: Southern, Central and Northern regions. Each Region has an independent Water Board owned by Government to supply it with portable water. The Constitution of the Republic of Malawi 1994, Chapter 3, Section 13 recognizes public trust and good governance as some of the fundamental principles of National Policy and thereby promised to introduce measures which will guarantee accountability, transparency, personal integrity and financial probity and which by virtue of their effectiveness will strengthen confidence in public institutions. In order to improve service delivery and fulfill the stated constitutional imperatives, the Malawi Government issued the following statement in 2008, one of our cardinal agenda is reform aimed at changing the way things are done in the public service so that it becomes more efficient and responsive to the needs of all Malawians. As a Government we realize that no matter how brilliant plans and development agenda can be, they will be frustrated unless major reforms are initiated and implemented to facilitate required changes to support the development process. Major changes are necessary in values, beliefs, norms, attitudes and mindsets to help create an enabling environment for the effective management of reforms across the public service. We need to move away from the business as usual type of attitude and fully account for time that we are paid for from public funds if we are to join the prosperous nations (National Framework for Public Sector Management Reform, June, 2008).
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- Date Issued: 2012
An investigation into the implementation of the basic antenatal care programme by midwives in Mdantsane clinics
- Authors: Dyeli, Nolwando
- Date: 2011
- Subjects: Primary health care -- South Africa -- Eastern Cape , Midwifery -- South Africa -- Eastern Cape , Childbirth -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Pregnancy -- South Africa -- Eastern Cape , Prenatal care -- South Africa -- Eastern Cape , Pregnant women -- Health and hygiene -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MSc (Nursing Science)
- Identifier: vital:11897 , http://hdl.handle.net/10353/425 , Primary health care -- South Africa -- Eastern Cape , Midwifery -- South Africa -- Eastern Cape , Childbirth -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Pregnancy -- South Africa -- Eastern Cape , Prenatal care -- South Africa -- Eastern Cape , Pregnant women -- Health and hygiene -- South Africa -- Eastern Cape
- Description: Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.
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- Date Issued: 2011